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Auditors are urging state health officials to explore how to get COVID-19 test results to patients faster and to be more transparent about that process, as Utah on Wednesday reported another 421 confirmed cases and six new deaths.
“Quick test turnaround times are essential in slowing the spread of the virus,” wrote the authors of the report, released Tuesday by the Utah Legislature’s Office of the Legislative Auditor General.
Rich Saunders, the Utah Department of Health’s new interim executive director, said his agency concurred with five recommendations the auditors made, and aims to have the changes in place by the end of August.
According to the Wednesday daily report from UDOH, the number of COVID-19 tests processed in a day went up noticeably, to 5,366 tests, compared to the week’s average, And the seven-day average of positive test results crossed 10%, as it had twice in July.
The state’s overall death toll stands at 327 people, with the six new deaths. One was a Utah County woman, older than age 85, who was a resident of a long-term care facility. The other five — two Davis County men, a Kane County woman, a Salt Lake County woman and a San Juan County man — were between the ages of 65 and 84, and were each hospitalized when they died.
The state reported that 184 people remained hospitalized as of Tuesday with COVID-19.
The state’s rolling seven-day average for new cases — the metric public-health officials use to gauge trends — is at 438 cases per day. The average for the seven days before that, which included the Pioneer Day holiday, was 516 per day.
The seven-day rate of positive results moved higher, to 10.1%; it had been 9.8% on Monday and Tuesday. It had previously reached 10.3 on July 17 and 10.2 on July 18. State epidemiologist Dr. Angela Dunn has said a rate of about 3% would indicate the virus is under control.
In the last seven days, Utah’s labs have averaged processing 4,590 tests per day. For the previous seven days, the average was 5,255 per day.
How fast those tests are processed — and how fast results get to health care providers and to patients — is an area where labs can improve and UDOH should be more transparent, the new legislative audit found.
It takes, on average, 38 hours — more than a day and a half — from when a patient is swabbed to when his or her health care provider is told the results of the test, the audit found. That figure could swing significantly, from 1.3 days to 3.7 days, depending on the lab.
Reasons for delays range included strained testing resources, limited staffing, transportation issues (particularly outside the Wasatch Front), and problems entering test data into the state’s system.
There was no data for what auditors called “the most critical measure”: How long it takes for that information to get to the patient who’s waiting, often quarantined, for the results.
The audit noted that providers are not required to tell UDOH when results are sent to patients, and auditors expressed concern that one provider stopped calling patients with negative test results when caseloads increased in June and July. (Patients often learned of their results by looking up their case file online.)
The auditors made five recommendations to UDOH and Gov. Gary Herbert’s office:
• Set a goal for test processing times (how soon providers get test results) and complete turnaround times (how soon patients get test results).
• Convene a commission to determine how feasible it is to collect and publish turnaround times.
• Study whether it’s feasible to post processing times, by lab and geographic location, on the UDOH’s coronavirus dashboard.
• Work with labs and providers to share best practices, to encourage greater efficiencies to reduce turnaround times.
• Review whether it’s feasible to shift test samples from backlogged labs to labs with greater capacity.
Kristen Cox, executive director of the Governor’s Office of Management and Budget, said the audit “will strengthen the focus and need to improve operations, especially testing cycle times.”
In a joint statement Wednesday, the leaders of the Utah Legislature — Senate President Stuart Adams, R-Layton, and Speaker Brad Wilson, R-Kaysville — said they “fully support” the audit’s recommendations, singling out the idea of publishing test turnaround times “to increase transparency.”